Introduction: Spinal cord stimulation (SCS) is an evidence-based therapeutic modality for chronic pain syndromes that do not respond to conservative therapy. One of the most common surgical indications is failed back surgery syndrome (FBSS).
Objectives: We performed a long-term follow-up of patients operated for FBSS with spinal cord stimulation, separately investigating changes in lower extremity and axial pain and their quality of life before and after surgery.
Material and method: Spinal cord stimulation was used to treat 124 patients with chronic pain between 2003. and 2021. The spinal pain syndromes were FBSS (n=51), degenerative scoliosis (n=10). Patients who had undergone surgery for an average of 6.1 (±3.4) years were selected for long-term follow-up (FBSS: n=16, degenerative scoliosis: n=4, total 20 patients, mean age: 66.4 years, range 43-82 years, female:male=16:4). Face-to-face and telephone assessments were performed before surgery and at the last follow-up with the following tests: pain intensity was analysed with the Visual Analogue Scale and quality of life with the Oswestry Disability Questionnaire. Lower limb and axial pain were assessed separately.
Results: Of 61 patients with chronic spinal pain syndrome, 20 were eligible for long-term (6-year) follow-up. Their Visual Analogue Scale scores and Oswestry Disability Index demonstrated significant improvement in both lower extremity and low back pain, as well as in quality of life, compared to preoperative data (p<0.05). Lower extremity pain improved from 9.6 preoperatively to 2.4 immediately postoperatively and 3.4 after 6 years of long-term follow-up according to VAS. VAS axial improved from 9.2 preoperatively to 3.9 immediately postoperatively and 4.8 after long-term follow-up. ODI improved from 86% preoperatively, to 34% immediately postoperatively, to 43% after long-term follow-up.
Conclusions: Our results suggest that spinal cord stimulation can be successfully used in the long term for the relief of lower extremity and axial pain of FBSS and degenerative scoliosis origin. Consistent with previous findings in the literature, our patients showed a more significant improvement in lower extremity pain than axial pain.